Is pembrolizumab-carboplatin-pemetrexed an acceptable initial therapy for metastatic non-squamous NSCLC regardless of PD-L1 status?
Does the recent FDA approval based on PFS and response rate in KEYNOTE-021 warrant it's use?
Answer from: Medical Oncologist at Academic Institution
In my opinion, the approval of Pembro-chemo for 1st line therapy of non-squam NSCLC, based on the small randomized Phase II KEYNOTE 021 trial, with no link to PD-L1 expression, was premature. The implications are so great that waiting a few months for the Phase III results is warranted. Afteral...
Answer from: Medical Oncologist at Academic Institution
Results from the phase III KEYNOTE 189 had been recently reported and published. This follow-up study provided the confirmatory OS benefit signal that had been awaited regarding chemo+immunotherapy in nonsquamous NSCLC. Improvement in OS was seen across all PD-L1 categories. Key points to consider a...
Comments
Medical Oncologist at Plano Cancer Inst The tempo of the disease is important... time for ...
Answer from: Medical Oncologist at Academic Institution
I am concerned about the FDA approval of the Pembro-chemo combination based upon a 123 patient study with a primary endpoint of ORR. I was taught that small randomized studies are good for prompting larger definitive studies that should answer the question. Indeed, these studies are ongo...
Answer from: Medical Oncologist at Academic Institution
I consider the approval to be premature for the reasons already stated by Drs. Gandara and Otterson. Given the large population of patients involved I believe it is wise to await confirmatory data before applying this regimen to all (or even most) patients with newly diagnosed metastatic nonsqu...
Answer from: Medical Oncologist at Community Practice
I'm reasonably impressed with the data, the PFS of 13-14mo seems very promising, the median time to response is only 1.5months, it's irrespective of PD-L1 expression, though I think in subset analysis, PD-L1 overexpressors had a response rate of 80% with all cohorts, RR of about 52% or so.
So, I wo...